Statins: The Pros and Cons

Cholesterol — a fat-like waxy substance found in all cells — is necessary for the body to function. However, if you have too much cholesterol in your system, you can be at greater risk for heart disease and other vascular diseases. It can cause a buildup of plaque in the artery walls, which affects blood flow and can raise your risk for a heart attack. Medications called statins can help to regulate cholesterol levels and may help address other health issues, too, although they are not without risk.

Statins are a class of prescription drugs that help to lower cholesterol. Statins block the enzyme that the body uses to make cholesterol in the liver. The liver, along with other cells in the body, makes about 75 percent of the body’s cholesterol. By blocking this enzyme, the amount of cholesterol your liver makes is significantly reduced.

Various types of statins are available. They all work similarly and offer the same level of effectiveness, but one might work better for you than another. Your doctor will prescribe a statin based on your cholesterol level and other risk factors for cardiovascular disease. You may need to try two to three different statins before finding the one that’s the most effective for you.

Most statins successfully help lower low-density lipoproteins, also known as LDL or “bad” cholesterol. Lowering your cholesterol levels with statins helps decrease your risk of stroke, heart attack, and other vessel-related diseases. “They work better than any other cholesterol treatment,” says Richard N. Fogoros, M.D., a cardiologist and former professor of medicine.

Statins offer other benefits besides lowering your cholesterol. For example, they help stabilize the blood vessel lining, which benefits the whole body. This also makes plaque less likely to rupture in the heart, lowering the risk of a heart attack. Statins also help to relax the blood vessels, which leads to a decrease in blood pressure.

The most common side effects of statins include nausea, vomiting, and aches and pains in the muscles and joints. You may also have constipation, gas, or diarrhea. As your body adjusts to the medication, the side effects often go away.

Some more serious side effects include:

type 2 diabetes or higher blood sugar

confusion and memory loss

liver damage

muscle damage

kidney damage

Not everyone who takes a statin has side effects. According to the Mayo Clinic, you’re more likely to experience side effects if you:

are female

are 65 or older

have type 1 or 2 diabetes

take multiple medications to lower your cholesterol

have a smaller body frame

have liver or kidney disease

consume too much alcohol

If you’re experiencing side effects, your doctor may want you to try another statin or change your dose, or try a different medication.

Pros

reduces risk of narrowed arteries

helps fight inflammation, which can reduce artery damage

Statins can have many benefits once you begin taking them. According to, the Journal of Cardiovascular Pharmacology and Therapeutics, statins may do more for your arteries than just lower cholesterol. Research indicates that statins can help reduce the risk of narrowed arteries. Statins can do this by keeping the smooth muscle lining of the arteries healthy and reducing the deposits of fibrin in the arteries. Fibrin is a type of protein involved in blood clot formation.

Researchers also suggest that statins may help fight inflammation, which reduces the chance of damage to your arteries.

The Archives of Internal Medicine said, that even with modest improvement in blood pressure from statin use, the risk of heart attack and stroke will still diminish.

Statins are also shown to reduce the risk of heart attacks, strokes, and other cardiovascular diseases by over 20 percent.

Cons

In a study of 83,000 people, the side effects were only present in a minority. There were just as many of the same symptoms listen by people using the placebo.

To address the possibility of getting diabetes, the same study stated that most people on statins are already at risk of diabetes. The statins may just help bring it on sooner. The numbers were not too serious with 3 percent developing it, compared to the 2.3 percent on the placebo.

Most people are able to take statins with no problems at all. The most common side effects of statins are mild. One is muscle pain, but that often goes away as the body adjusts to the drug. There is also a slight risk of feeling dizzy while on statins. These symptoms don’t occur in most people who take statins.

There is also negative health reactions to mixing statins with grapefruit. The grapefruit can cause an increase to the side effect of the drugs. This could put you at risk for muscle breakdown, liver damage and kidney failure. More mild cases can cause pain the joints and muscles.

The mix of the two suppress the ability of an important enzyme. The enzyme normally helps the body process the medication. It balances out how much of it goes to the bloodstream. The compounds hinder the enzyme, and create higher amounts of the drug in the bloodstream.

Taking statins is often (but not always) a lifelong commitment. Even if your cholesterol levels decrease, you may still need to take the medication. Otherwise, your levels will likely go back up once you’re off the meds.

However, if you change your lifestyle significantly, you may be able to go off the medication. This might include losing a significant amount of weight or radically changing your diet.

foods fortified with plant-based substances called stanols, such as yogurt drinks, margarines, or orange juice

whole-grain, high-fiber, unprocessed grains

Quitting Smoking

If you smoke, stopping can help improve your cholesterol levels, lower your blood pressure, and decrease your risk of a heart attack, according to the Mayo Clinic. The benefits of quitting smoking begin within hours, adds Dr. Fogoros.

Exercise

Losing excess weight — even five to 10 pounds — and regularly engaging in physical activity can help improve your cholesterol numbers. Walk, bike, swim, or do anything to get your heart pumping. Talk with your doctor before starting any fitness regimen.

If you suffer from serious side effects or aren’t a statin candidate, your doctor may prescribe another type of medication to treat your cholesterol.

Cholesterol Absorption Inhibitor

The Mayo Clinic says that the small intestine absorbs your diet’s cholesterol and releases it into the bloodstream. A cholesterol absorption inhibitor helps to limit this absorption of cholesterol you consume.

Bile Acid Sequestrant

The liver makes bile acids, needed for digestion, using cholesterol. Sequestrants bind to bile acids, making the liver use the extra cholesterol to produce more bile acids. And that lowers the cholesterol in the blood.

Combination Cholesterol Absorption Inhibitor and Statin

This combination drug lowers the absorption of cholesterol in your small intestine and your liver’s cholesterol production.

Medically reviewed by Alan Carter, PharmD on March 29, 2016 — Written by Stacey Feintuch and Justin Sarachik